Article

Number of Risk Acts by Relationship Status and Partner Serostatus: Findings from the HIM Cohort of Homosexually Active Men in Sydney, Australia

National Centre in HIV Social Research, University of New South Wales, Sydney, Australia.
AIDS and Behavior (Impact Factor: 3.49). 06/2006; 10(3):325-31. DOI: 10.1007/s10461-005-9057-3
Source: PubMed

ABSTRACT In recent years, increases in both risk behavior and in seroconversion among homosexually active men have been noted in a number of parts of the world. Data were available from 903 HIV negative homosexual men regarding number of acts of unprotected anal intercourse (UAI), separated into receptive and insertive UAI, with and without ejaculation, with steady and with casual partners. Partners were classified according to serostatus as reported by respondents. Men (N = 325) reported 13,692 UAI acts, most of which were with steady partners, of whom most were reported to be HIV-negative. With HIV-positive partners, both steady and casual, and with casual partners of unknown serostatus, receptive UAI with ejaculation was relatively rare. Insertive UAI without ejaculation was relatively common with casual partners of unknown serostatus. Patterns of UAI suggest that risk of transmission may be greater with steady partners. Men appear to modify practice according to both the nature of the relationship (steady or casual) and (assumed) serostatus of partner.

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    • "One possible explanation, as consistently reported by behavioral studies, may be that gay men in relationships engage in substantially higher rates of unprotected anal intercourse (UAI) with their primary partners than do single men with their casual partners (Cáceres & Rosasco, 1997; Ekstrand, Stall, Paul, Osmond, & Coates, 1999; Elford, Bolding, Maguire, & Sherr, 1999; Fitzpatrick, McLean, Dawson, Boulton, & Hart, 1990; Hays, Kegeles, & Coates, 1990, 1997; Hoff, Coates, Barrett, Collette, & Ekstrand, 1996; Hoff et al., 1997; Hope & MacArthur, 1998; Kippax, Crawford, Davis, Rodden, & Dowsett, 1993; Schmidt, Fouchard, Krasnik, & Zoffmann, 1992). Recent studies confirm high rates of unprotected sex among gay couples (Crawford et al., 2006; Davidovich et al., 2001; Stolte, Dukers, Geskus, Coutinho, & de Wit, 2004; Xiridou, Geskus, De Wit, Coutinho, & Kretzschmar, 2003). While UAI may not inherently present risk for HIV transmission (e.g., if the couple is concordant negative and monogamous), other factors, such as serostatus differences between partners, may increase the likelihood of HIV transmission. "
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